This invention comprises an improvement over the invention described and claimed in applicant's copending application Ser. No. 515,857, filed Oct. 18, 1974 and now U.S. Pat. No. 3,965,890.
The retractor described in the aforesaid patent application is designed to hold open an incision and to retain the bowel or intestines in the abdominal cavity, and for its intended purpose, the aforesaid surgical retractor performs exceptionally well.
However, in some kinds or types of deep abdominal surgery, such as a resection and excision of large bowel, or where kidneys are removed through an abdominal incision rather than through a flank incision, or in a deep abdominal incision for a lumbar sympathectomy or in vascular surgery for correction of aneurysms or blood clots or constricted areas of the large arteries and veins, it is necessary to remove the intestines from the abdominal cavity and drape them to one side thereof in order to provide adequate access to the working area. In such types of surgery, the surgical retractor described in the aforesaid patent application is not entirely satisfactory, since although it functions exceptionally well to retain the walls of the abdomen open or spread at the incision, the individual blades theeof which are normally applied to retract the intestines back into the abdominal cavity cannot be used, since the intestines must be removed from the cavity and draped to one side, and thus they are in the way of attachment of the retractor arm in the aforesaid application to the frame. Moreover, in the prior art it is necessary during such surgery for someone on the operating team to hold the exposed bowel and messentery out of the way during the surgical procedure. This is typically done either with the hands or with deaver retractors. It is readily apparent that such a procedure is difficult and inefficient, even for relatively quickly performed surgery, and when an operation or surgical procedure is long and drawn out, the procedure necessarily followed in the prior art is entirely unsatisfactory.
With the present invention, on the other hand, an extension is applied to the conventional retractor frame of the type disclosed, for example, in the aforesaid patent application, and a conventional retractor arm and ratchet means also of the type described in the aforesaid patent application are then applied to the extension in an elevated position above the frame, leaving a space between the arm and frame in which the intestines may be placed, and the retractor arm may then be retracted, with a blade carried thereby engaging the intestines to retain them in position out of the abdominal cavity. This arrangement is far superior to the prior art methods, wherein the intestines are either hand held or held with deaver retractors, and moreover, with the present invention more than one retractor blade can be attached to the extension or extensions and engaged with the gathered together intestines, thus reducing the possibility of damage to the intestines and also freeing operating personnel for other duties during a surgical procedure.